Watchful waiting for small non-functional pancreatic neuroendocrine tumours: nationwide prospective cohort study (PANDORA)
Charlotte M. Heidsma, Anton F. Engelsman, Susan van Dieren, Martijn W.J. Stommel, Ignace H. J. T. de Hingh, Menno R. Vriens, Lieke Hol, Sebastiaan Festen, Leonie J. Mekenkamp, Frederik J.H. Hoogwater, Freek Daams, H -J Klümpen, Marc G. Besselink, Casper H.J. van Eijck, E J Nieveen van Dijkum
Abstract
This prospective nationwide cohort study examined the feasibility of a watchful-waiting protocol for non-functional pancreatic neuroendocrine tumours (NF-pNET) of 2 cm or smaller. In total, 8 of 76 patients (11 per cent) with a NF-pNET no larger than 2 cm showed significant tumour progression (more than 0.5 cm/year) during 17 months of follow-up, of whom two opted for resection. No patient developed metastases. Quality of life was poorer than in the reference population. Watchful waiting seems a safe alternative to upfront surgery in patients with a NF-pNET no larger than 2 cm, although longer follow-up is necessary.